Risk factors for intraoperative hypothermia in patients receiving lung transplants

Area of Science:

• Cardiology
• Thoracic Surgery
• Anesthesiology

Background:

• Intraoperative hypothermia (IOH) is common in lung transplantation, impacting patient morbidity and mortality.
• Preventing IOH is critical for improving perioperative outcomes in lung transplant recipients.
• Identifying risk factors and developing predictive models for IOH are essential.

Purpose of the Study:

• To identify risk factors associated with IOH in lung transplant patients.
• To develop and validate a predictive risk model for IOH.
• To guide clinical practice in screening high-risk individuals.

Main Methods:

• A logistic regression model and nomogram were developed using data from 160 lung transplant patients.
• Patients were categorized into hypothermic (n=106) and non-hypothermic (n=54) groups.
• Model performance was assessed using ROC curves and calibration curves.

Main Results:

• The incidence of IOH was 66.25%.
• Increased intraoperative fluid volume was a risk factor for IOH (OR=1.001, P<0.001).
• Extracorporeal membrane oxygenation (ECMO) (OR=0.091, P<0.001) and circulating-water mattresses (OR=0.389, P=0.02) were protective.
• IOH was associated with cardiac arrhythmias but not LOS in ICU, AKI, hemorrhage, or 30-day mortality.
• The predictive model demonstrated good diagnostic efficacy (AUC=0.820).

Conclusions:

• A validated risk prediction model for IOH in lung transplantation has been developed.
• The model effectively identifies patients at high risk for IOH.
• This tool can assist clinicians in proactive IOH management during lung transplantation.